Degradation of Ciprofloxacin in Water by Magnetic-Graphene-Oxide-Activated Peroxymonosulfate.

Antibiotics are extensively applied in the pharmaceutical industry, while posing a tremendous hazard to the ecosystem and human health. In this study, the degradation performance of ciprofloxacin (CIP), one of the typical contaminants of antibiotics, in an oxidation system of peroxymonosulfate (PMS) activated by magnetic graphene oxide (MGO) was investigated. The effects of the MGO dosage, PMS concentration and pH on the degradation of CIP were evaluated, and under the optimal treatment conditions, the CIP degradation rate was up to 96.5% with a TOC removal rate of 63.4%. A kinetic model of pseudo-secondary adsorption indicated that it involves an adsorption process with progressively intensified chemical reactions. Furthermore, the MGO exhibited excellent recyclability and stability, maintaining strong catalytic activity after three regenerative cycles, with a CIP removal rate of 87.0%. EPR and LC-MS experiments suggested that •OH and SO4-• generated in the MGO/PMS system served as the main reactants contributing to the decomposition of the CIP, whereby the CIP molecule was effectively destroyed to produce other organic intermediates. Results of this study indicate that organic pollutants in the aqueous environment can be effectively removed in the MGO/PMS system, in which MGO has excellent catalytic activity and stabilization for being recycled to avoid secondary pollution, with definite research value and application prospects in the field of water treatment.

Efficacy of prognostic nutrition index in combination with D-dimer in predicting postoperative clinical adverse events after acute type A aortic dissection: a single center retrospective study.

Background: The aim of this study was to identify the predictive factors for adverse clinical events after surgery in patients with acute type A aortic dissection (AAAD), and to explore the predictive value of preoperative prognostic nutritional index (PNI) combined with D-dimer for these events. Methods: This study was a retrospective analysis of clinical data of 153 patients with AAAD who underwent emergency surgery at our center from January 2019 to January 2022. Patients were divided into adverse event group and non-adverse event group based on whether they experienced adverse clinical events after surgery. Univariate and multivariable logistic regression analyses were performed to identify the risk factors for adverse events, and the predictive efficacy was evaluated by the area under the receiver operating characteristic curve (ROC-AUC). Results: A total of 153 AAAD patients were included in the study, and were divided into the adverse event group (n = 46) and the non-adverse events group (n = 107) based on whether or not they experienced clinical adverse events after surgery. The optimal cutoff value was determined using ROC curves, and multivariate logistic regression analysis was performed. Ultimately, it was found that preoperative PNI < 42.45 and D-dimer > 15.05 were independent predictors of postoperative clinical adverse events in AAAD patients. The odd ratios (OR) value for preoperative PNI < 42.45 is 3.596 [95% Confidence Interval (CI): 1.508-8.923, p = 0.004], while the OR value for D-dimer > 15.05 is 7.572 [95% CI: 3.094-20.220, p < 0.001]. The combination of these two indicators has a high predictive value (AUC = 0.843, 95% CI: 0.774-0.912, p < 0.001) and is superior to using either variable alone. Conclusion: Preoperative PNI < 42.45 and D-dimer > 15.05 are independent predictive factors for postoperative adverse events during hospitalization in patients with AAAD. The combination of these two indicators can improve the predictive accuracy, which is superior to using either variable alone.

Do obese patients with type A aortic dissection benefit from total arch repair through a partial upper sternotomy?

Background: Minimal research has been performed regarding total arch replacement through partial upper sternotomy in patients with acute type A aortic dissection who are obese, and the safety and feasibility of this procedure need to be further investigated. The present study investigated the potential clinical advantages of using a partial upper sternotomy versus a conventional full sternotomy for total arch replacement in patients who were obese. Methods: This was a retrospective study. From January 2017 to January 2020, a total of 65 acute type A aortic dissection patients who were obese underwent total arch replacement with triple-branched stent graft. Among them, 35 patients underwent traditional full sternotomy, and 30 patients underwent partial upper sternotomy. The perioperative clinical data and postoperative follow-up results of the two groups were collected, and the feasibility and clinical effect of partial upper sternotomy in total arch replacement were summarized. Results: The in-hospital mortality rates of the two groups were similar. The total operative time, cardiopulmonary bypass, aortic cross-clamp, cerebral perfusion, and deep hypothermic circulatory arrest times were also similar in both groups. The thoracic drainage and postoperative red blood cell transfusion volumes in the partial upper sternotomy group were significantly lower than those in the full sternotomy group. Mechanical ventilation time was shorter in the partial upper sternotomy group than that in the full sternotomy group. Additionally, the incidences of pulmonary infection, hypoxemia, and sternal diaphoresis were lower in the partial upper sternotomy group than those in the full sternotomy group. Conclusion: This study showed that total arch replacement surgery through a partial upper sternotomy in patients with acute type A aortic dissection who are obese is safe, effective, and superior to full sternotomy in terms of blood loss, postoperative blood transfusion, and respiratory complications.

Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score.

BACKGROUND: This study was aimed to investigate the incidence and outcomes of patients with postoperative hepatic dysfunction (PHD) after total arch repair of acute type A aortic dissection, and further explore the risk factors for severe adverse outcomes. METHODS: The clinical data of 227 patients with AAAD treated by modified triple-branched stent graft implantation from January 2020 to January 2021 were collected retrospectively. Including preoperative, surgical and postoperative data. Logistics regression was used to determine the independent risk factors of severe adverse outcomes in postoperative HD patients. RESULTS: In the early stage after operation, a total of 153 patients were complicated with PHD, accounting for 67.4%. The incidence of severe adverse outcomes in patients with PHD was 43.1%. We found that preoperative moderate/severe pericardial effusion [odds ratio (OR): 11.645, 95% confidence interval (CI): 1.144, 143.617, P = 0.045], preoperative imaging data suggest the celiac trunk involvement [OR: 6.136, 95% CI 1.019, 36.930, P = 0.048], CPB time > 180 min [OR: 4.855, 95% CI 1.218, 15.761, P = 0.034], decreased early postoperative serum albumin [OR: 0.935, 95% CI 0.856, 0.985, P = 0.026] were independent risk factors for severe adverse outcomes in patients with PHD. CONCLUSIONS: PHD was associated with increased early mortality and morbidity. Preoperative moderate/severe pericardial effusion, preoperative celiac trunk involvement, cardiopulmonary bypass (CPB) time > 180 min and decreased early postoperative serum albumin were identified as independent risk factors for severe adverse outcomes in patients with PHD.

Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection.

Objective: To compare the efficacy of the percutaneous presuture technique (PPST) and the femoral artery incision technique (FAIT) under local anesthesia in the treatment of endovascular aortic repair (EVAR) for patients with uncomplicated type B aortic dissection (uTBAD). Method: Two hundred and ninety-five patients diagnosed with uTBAD who underwent EVAR under local anesthesia from June 2017 to December 2021 were consecutively and randomly selected for retrospective analysis. The PPST was performed in 178 cases and the FAIT was performed in 117 cases. The clinical characteristics and surgical and postoperative data from the two groups were analyzed. Results: There were no significant differences in clinical characteristics between the two groups (p > 0.05). The operative time of the PPST group was significantly shorter than that of the FAIT group (46 (33, 58) versus 72 (67.5, 78.0) minutes, p < 0.001), as was the operative approach procedure time (6 (4.5, 9.0) versus 38 (36.5, 43.5) minutes, p < 0.001), and length of postoperative hospital stay (5.19 ± 2.26 versus 8.33 ± 3.76 days, p < 0.001). There were fewer postoperative approach-related procedural complications in the PPST group than in the FAIT group (2 versus 12, p < 0.001); similarly, the average frequency of postoperative wound disinfection was significantly lower in the PPST group (1.08 ± 0.39 versus 3.31 ± 0.91 times, p < 0.05). Obesity was identified as an independent risk factor for postoperative approach-related procedural complications (OR, 22.26; 95% CI, 4.74-104.49; p < 0.001). Conclusions: The PPST has comparable safety and efficacy to the FAIT in EVAR under local anesthesia. It can shorten the length of hospital stay, reduce operation time, lower the risk of wound-related complications, reduce the frequency of postoperative wound disinfection, and hasten postoperative recovery. It can therefore be used as a first-line surgical technique in EVAR of uTBAD under local anesthesia, especially in obese patients.

Do obese patients benefit from isolated aortic valve replacement through a partial upper sternotomy?

OBJECTIVE: Controversial opinions exist for aortic valve replacement (AVR) through partial upper sternotomy in obese patients. Moreover, this study sought to investigate the potential clinical advantage of partial upper sternotomy aortic valve replacement (mini-AVR) over conventional full sternotomy aortic valve replacement (con-AVR) in obese patients. METHODS: This was a retrospective and observational study. From January 2015 to December 2020, a total of 184 obese [body mass index (BMI) ≥ 30 kg  m2] patients undergoing isolated primary AVR were included: 98 patients underwent conventional full sternotomy, and 86 patients underwent partial upper sternotomy. Propensity score (PS) matching was applied to eliminate the bassline imbalances in the mini-AVR and the con-AVR groups. RESULTS: After one-to-one propensity score matching, two groups of 60 patients were obtained. No in-hospital death occurred in the two groups. In addition, cardiopulmonary bypass time and total operative time were similar across the 2 groups, but the aortic cross-clamp time was significantly shorter in the con-AVR group (P = .0.022). The amount of mediastinal drainage at 48 h after surgery (P = 0.018) and postoperative blood transfusions (P = 0.014) were significantly lower in the mini-AVR group. There was no difference in ventilation time (P = .0.145), but a shorter intensive care unit stay time (P = 0.021) in the mini-AVR group. CONCLUSION: This study demonstrates that aortic valve replacement through a mini-AVR in obese patients is a safe and effective procedure. It outperformed con-AVR in terms of blood loss, blood product transfusion, and ICU stay.

Temporal and Spatial Distribution Analysis of Atmospheric Pollutants in Chengdu-Chongqing Twin-City Economic Circle.

In order to study the temporal and spatial distribution characteristics of atmospheric pollutants in cities (districts and counties) in the Chengdu-Chongqing Twin-city Economic Circle (CCEC) and to provide a theoretical basis for atmospheric pollution prevention and control, this paper combined Ambient Air Quality Standards (AAQS) and WHO Global Air Quality Guidelines (GAQG) to evaluate atmospheric pollution and used spatial correlation to determine key pollution areas. The results showed that the distribution of atmospheric pollutants in CCEC presents a certain law, which was consistent with the air pollution transmission channels. Except for particulate matter with an aerodynamic diameter equal to or less than 2.5 µm (PM2.5) and ozone (O3), other pollutants reached Grade II of AAQS in 2020, among which particulate matter with an aerodynamic diameter equal to or less than 10 µm (PM10), PM2.5, sulfur dioxide (SO2), nitrogen dioxide (NO2) and carbon monoxide (CO) have improved. Compared with the air quality guidelines given in the GAQG, PM10, PM2.5, NO2 and O3 have certain effects on human health. The spatial aggregation of PM10 and PM2.5 decreased year by year, while the spatial aggregation of O3 increased with the change in time, and the distribution of NO2 pollution had no obvious aggregation. Comprehensive analysis showed that the pollution problems of particulate matter, NO2 and O3 in CCEC need to be further controlled.

Structural insight into the alginate derived nano-La(OH)3/porous carbon composites for highly selective adsorption of phosphate.

In this study, a novel nano-La(OH)3/porous carbon composites derived from La alginate xerogel with egg-box structure had been successfully synthesized by a gradient heat treatment in nitrogen atmosphere. This facile fabrication strategy can be easily employed to considerably encapsulate La(OH)3 nanoparticles uniformly into the porous carbon matrix derived from the alginate macromolecule framework. The optimized sample, labeled as LS-550(N), exhibited extremely high phosphate uptake and great selectivity. The adsorption kinetic process dramatically followed pseudo-second-order model. The Langmuir model fitted maximum equilibrium adsorption capacity is 133.58 mg·g-1. The phosphate adsorption mechanisms could be consist of electrostatic interaction, complexation and ligand exchange interaction on the surface of LS-550(N). The prominent practical applicability of LS-550(N) in the regeneration test suggests that the LS-550(N) could be a potential adsorption candidate for the decontamination of phosphate-containing natural water bodies.

Extensive repair of acute type A aortic dissection through a partial upper sternotomy and using complete stent-graft replacement of the arch.

BACKGROUND: Partial upper sternotomy (mini-ER) can be used in some adult cardiac surgeries but is seldom performed in the treatment of acute type A aortic dissection (AAAD). This study aimed to assess the feasibility and short-term outcomes of complete stent-graft replacement of the arch with triple-branched stent graft for AAAD through a mini-ER. METHODS: From 2015 to 2018, 254 patients with AAAD underwent complete stent-graft replacement of the arch with a triple-branched stent graft. Replacement was performed with conventional full sternotomy (con-ER) in 142 patients and with mini-ER in the other 112 patients. Using propensity score matching, the clinical data were compared between 100 patients in the mini-ER group and 100 patients in the con-ER group. RESULTS: After propensity score matching, there were no significant between-group differences in aortic cross-clamp time, cardiopulmonary bypass time, or total operative time. The amount of mediastinal drainage and number of red blood cell units were significantly lower in the mini-ER group compared with the con-ER group (P < .001). The intubation time was significantly shorter in the mini-ER group (P < .001). The treatment costs were also lower in the mini-ER group (P < .001). There were no significant between-group differences in 30-day mortality (9% vs 8%; P > .99) or postoperative complications. CONCLUSIONS: This study shows that extensive repair of AAAD through a mini-ER is feasible. It was superior to con-ER in terms of blood loss, postoperative ventilation time, and treatment costs.

Early Efficacy of In Situ Fenestration with a Triple Chimney Technique for High-Risk Stanford Type A Aortic Dissection: A Single-Center Retrospective Study.

PURPOSE: The objective of this investigation was to study the early efficacy of in situ fenestration with triple chimney technique for high-risk type A aortic dissection patients. METHODS: This study included 24 patients who were treated by in situ fenestration with TCT for high-risk TAAD between January 2018 and December 2019. Multiple comorbidities or preoperative critical conditions rendered patients ineligible for open surgery, but all patients that were evaluated and considered had to undergo operation. By analyzing the regular follow-up data, the early postoperative efficacy of the patients was evaluated. RESULTS: The average age of the 24 patients was 65.4 ± 9.3 years. The success rate of the operation was 100%, as all the patients were discharged successfully. There were no serious neurological complications or persistent endoleakage. The mean follow-up time was 21.4 ± 6.9 months. The patency rate of all branching stents was 100%, with no stent displacement, stenosis, or blockage observed. While none presented with type I endoleakage, one patient (4.2%) presented asymptomatic type II endoleakage around the left subclavian artery stent. Currently, 23 of the 24 patients remain alive. CONCLUSION: Initial results are encouraging with TCT for high-risk TAAD. However, due to its high selectivity and potential complexity related to surgical risks, the mid- and long-term efficacy of this technique remains unknown. For patients who are eligible for open heart surgery, we still recommend it be performed.

Tuning parallel manganese dioxide to hollow parallel hydroxyl oxidize iron replicas for high-performance asymmetric supercapacitors.

A novel and facile strategy is developed to tune parallel manganese dioxide (MnO2) to hollow parallel hydroxyl oxidize iron (FeOOH) replicas, which can exactly keep its original morphology. The key factors leading to the morphology-preserved transformation are the low-temperature and dropwise strategy via a serial of controlled experiments. Benefiting from the characteristics of parallel and hollow structures, the FeOOH replica delivers remarkable specific capacitance of 186.8F g-1 at 0.5 A g-1. The electrochemical performances delivered by the asymmetric supercapacitor (parallel MnO2//hollow parallel FeOOH) are much superior to those where conventional activated graphene or FeOOH nanoneedles are used as negative electrode materials. This can be attributed to the advantages of parallel nanostructure and high electrochemical matching effect of positive and negative electrode materials. The energy density is recorded up to 46.8 Wh kg-1 at the power density of 0.5 kW kg-1, while it still remains 20.7 Wh kg-1 with the maximum power density of 10 kW kg-1. Furthermore, this strategy shows great universality and can be broadened to almost all MnO2 related researches to synthesize ideal negative electrode materials with high structural and electrochemical matching effect, thus further enhances the electrochemical performances of as-prepared asymmetric supercapacitor devices.

Electron buffer formation through coupling thiosulfate-dependent denitratation with anammox in a single-stage sequencing batch reactor.

The combination of thiosulfate-dependent denitratation and anammox in a single-stage reactor provides a feasible way to improve total nitrogen removal. The molar ratios of NH4+/NO3- and S2O32-/NO3- were confirmed to be two key factors affecting the reactor performance. The optimal total nitrogen removal efficiency of 99.4% was achieved at NH4+/NO3- of 0.75 and S2O32-/NO3- of 0.85. The multiple thiosulfate oxidation pathways contribute to electron buffers generated in the system. A novel isotope labeling method using 15N was applied to reveal N transformation pathways and a 3-step model was proposed. The nitrate was first converted to nitrite or nitric oxide (NO) by sulfur-oxidizing bacteria. In the second step, both nitrite and NO were utilized by anammox bacteria. Finally, the nitrate generated from anammox could be removed using sulfur deposits as electron donors. The findings provide a potential solution for mainstream nitrogen removal.

One-step hydrothermal synthesis of Cu-doped MnO2 coated diatomite for degradation of methylene blue in Fenton-like system.

In this work, we have synthesized Cu-doped MnO2@diatomite successfully though a one-step hydrothermal approach. Meanwhile, application for degradation of methylene blue in Fenton-like system was investigated. The compounds were characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscope (XPS), Inductively Coupled Plasma analysis (ICP) and UV-vis spectroscopy measurements, beam scanning electron microscope (FIB/SEM), energy dispersive X-ray spectrometer (EDS). The observations revealed that copper was indeed intercalated into layered structure of MnO2 and Density functional theory (DFT) calculations predicted that Cu2+ intercalated MnO2@diatomite brought about the narrowing of band gap and the enhancing of charge mobility during catalysis. Electron Density Difference of CuMnD demonstrated excellent oxidation ability to dissociate H2O2 and generate hydroxyl radical (OH) to degrade the MB. Moreover, the proper copper doping of sample is more easily to form oxygen defect, which generate more surface hydroxyl groups as reaction sites for surface adsorption. In addition, the degradation efficiency of CuMnD was tremendously influenced by the initial pH, H2O2 dosage and copper content of catalyst. Ultimately, 0.02-25-CuMnD along with molar ration of Cu/Mn with 0.4402 showed the best degradation efficiency which was about 96.2% within 4 h with 16.5 mM of H2O2 and pH 2.06.

Acid-salt treated CoAl layered double hydroxide nanosheets with enhanced adsorption capacity of methyl orange dye.

In this study, the ultra-thin CoAl layered double hydroxide (LDH) nanosheets with Cl- intercalation were prepared by a hydrothermal method following acid-salt treatment. The morphology, structure and composition information of CoAl LDHs were identified by a variety of characterization methods including SEM, XRD, XPS, FT-IR, and BET. The effects of initial adsorbent concentration, pH, competitive anions, and temperature were also measured. The fitted adsorption curves are matched well with Langmuir isotherm model and pseudo-second-order kinetic model, suggesting that the removal of methyl orange (MO) is governed by monolayer heterogeneous adsorption and chemical adsorption, respectively. The measurements of adsorption capacity at various temperatures revealed that the adsorption process is spontaneous. Co-existing anions have different negative effects on the adsorption capacity. The Co4Al1-Cl LDH adsorbent shows the maximum experimental and theoretical adsorption capacity of 801.08 and 827.50 mg g-1 (pH = 7 and T = 293 K), respectively. An adsorption mechanism called "ion exchange and expansion-extrusion" is proposed to explain the change of interlayer spacing. These results indicate that a novel avenue for designing LDH-type adsorbent has been proposed with excellent adsorption capacity for anionic dyes like MO.